Anatomy of the Bones

Anatomy of the Skeletal System

Bone Anatomy

Compare the nuclear medicine scans to anatomical diagrams. What can you label/identify on the NMT exam. Spot views were taken of the chest, spine, hand, and foot.

Chest Anatomy	Chest Spot View

Comments on how does one improve the quality of a spot view (Chest) on a bone scan?

Wait 3 hours before you start the scan
Have the patient drink lots of water
Make sure the detector is as close to the patient as possible. Increased distance, increases scatter, and reduces resolution
Use a 256 x 256 matrix. You've got lots of counts so use a large matrix size
High count imaged require the use of a HR collimator

Anatomy of the Spine - Right Lateral View	Posterior Spine Spot View

Comments of spot view of the spine

The right lateral image defines the anatomy, however, only a posterior is available from an imaging standpoint
Can the anatomy of the different vertebrae be identified?
Define the anatomy on the acquired image

Anatomy of the Left Hand	Three Phase (and Pinhole) Bone Scan of Hand

Comments of the Three Phase of the hands

Increased activity is noted in both wrist in all phases of the procedure is an indication of of disease
However, the anatomy difference from a child to an adult. For this reason the growth plates have increased activity
Disease is specifically noted as a slight increase in activity in the second metacarpal
This is an example of a benign bone lesion known as osteoid osteoma
For more information visit http://www.med.harvard.edu/JPNM/CH/JS2/WriteUp.html

Anatomy of the Foot	Three Phase Bone Scan of the Feet

Comment on Three Phase Bone scan of the feet

Classic for osteomyelitis showing increased uptake in all three phases of the procedure
This patient also has diabetes mellitus that reduces blood circulation over time (~15-20 years) to the extremities, in turn this will increases the likelihood of infection, followed by amputation
Is it possible to identify the structures in the foot? Or is there too much background?
Why is there more background in this procedure as compared to all the others (above)?
In this specific patient, what might you do to improve target to background?
For more information about this procedure visit http://www.med.harvard.edu/JPNM/TF99_00/Sept21/WriteUp.html

http://ausnucmed.wordpress.com/2009/06/28/pelvic-kidney-on-bone-scan/

Application of SPECT

Degenerative changs in the right hip can be noted in the whole body bone scan
Why is there lack of activity in the left hip?
However, SPECT imaging also defines increased activity in L5 not seen in whole body and spot views

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8/19